目的 探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血清炎症发生区因子 2(found in inflammatory zone 2,FIZZ2)和白细胞介素-33(interleukin-33,IL-33)水平变化及与预后的相关性.方法 选取2020年1月～2023年1月中国科学院合肥肿瘤医院收治的102例AECOPD患者为AECOPD组,并根据预后分为生存组(n=30)和死亡组(n=72).以同期诊治的60例稳定期COPD患者为稳定期组,以同期体检的60例健康人为对照组.采用酶联免疫吸附实验(ELISA)法检测血清FIZZ2和IL-33水平.采用Pearson相关性分析血清FIZZ2和IL-33与肺功能指标的相关性.多因素Logistic回归分析影响AECOPD患者预后的因素.受试者工作特征(ROC)曲线分析血清FIZZ2和IL-33对AECOPD患者预后预测价值.结果 AECOPD组血清FIZZ2(212.19±48.47 ng/L),IL-33(66.19±13.41 μg/L)高于稳定期组(101.11±31.03ng/L,40.69±9.94μg/L)和对照组(42.33±7.65ng/L,26.17±8.10μg/L),差异具有统计学意义(t=15.925,26.915;12.799,20.961,均 P＜0.05).血清 FIZZ2,IL-33 水平与第一秒用力呼气容积占预计值的百分比(forced expiratory volume in one second/predicted value ratio,FEV1％pred)、第一秒用力呼气容积与用力肺活量比值(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)、动脉血氧分压(arterial partial pressure of oxygen,PaO2)呈负相关(r=-0.676,-0.707,-0.715;-0.662,-0.711,0.630,均P＜0.05),与动脉血二氧化碳分压(arterial carbon dioxide pressure,PaCO2)呈正相关(r=0.712,0.689,均 P＜0.05).死亡组血清FIZZ2(254.30±53.22 ng/L),IL-33(75.18±15.62 μg/L)高于生存组(194.64±47.16 ng/L,62.50±12.37 ng/L),差异具有统计学意义(t=5.604,4.354,均 P＜0.05).血清 FIZZ2(OR=1.445,95％CI:1.094～1.909),IL-33(OR=1.701,95％CI:1.111～2.602)是影响AECOPD患者预后独立危险因素.血清FIZZ2,IL-33二者联合对AECOPD患者预后的评估的曲线下面积(95％置信区间)为 0.886(0.842～0.927),高于各单项指标检测[0.834(0.798～0.890),0.806(0.779～0.846)],差异具有统计学意义(Z=4.255,4.697,均P＜0.05).结论 AECOPD患者血清FIZZ2,IL-33水平升高,两者与患者肺功能有关,两者联合检测对AECOPD患者的生存预后具有较高的预测价值.
Changes of Serum FIZZ2 and IL-33 Levels in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Their Correlation with Clinical Prognosis
Objective To investigate the changes in serum levels of the found in inflammatory zone 2(FIZZ2)and interleukin-33(IL-33)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their correlation with prognosis.Methods A total of 102 AECOPD patients admitted to Hefei Cancer Hospital of Chinese Academy of Sciences from January 2020 to January 2023 were selected as AECOPD group,and were divided into survival group(n=30)and death group(n=72)according to the prognosis.Meanwhile,60 stable COPD patients diagnosed and treated were selected as the stable period group,and 60 healthy individuals who underwent physical examinations at the same time were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of FIZZ2 and IL-33.Pearson correlation analysis was used to investigate the correlation between serum FIZZ2 and IL-33 with lung function indicators.Multivariate Logistic regression analysis was used to identify the factors affecting the prognosis of AECOPD patients.The predictive value of serum FIZZ2 and IL-33 in predicting the prognosis of AECOPD patients was analyzed by receiver operating characteristic(ROC)curve.Results In AECOPD group,serum FIZZ2(212.19±48.47 ng/L)and IL-33(66.19±13.41 μg/L)were higher than those in the stable phase group(101.11±31.03ng/L,40.69±9.94μg/L)and the control group(42.33±7.65ng/L,26.17±8.10μg/L),and the differences were significant(t=15.925,26.915;12.799,20.961,all P＜0.05).The serum levels of FIZZ2 and IL-33 were negatively correlated with the forced expiratory volume in one second/predicted value ratio(FEV1％pred),forced expiratory volume in one second/forced vital capacity(FEV1/FVC),and arterial partial pressure of oxygen(r=-0.676,-0.707,-0.715;-0.662,-0.711,0.630,all P＜0.05),but were positively correlated with arterial partial pressure of carbon dioxide(r-0.712,0.689,all P＜0.05).The serum FIZZ2(254.30±53.22 ng/L)and IL-33(75.18±15.62 μg/L)in the death group were higher than those in the survival group(194.64±47.16 ng/L,62.50±12.37 μg/L),and the differences were significant(t=5.604,4.354,all P＜0.05).Serum FIZZ2(OR=1.445,95％CI:1.094～1.909)and IL-33(OR=1.701,95％CI:1.111～2.602)were independent risk factors for the prognosis of AECOPD patients.The area under the curve(95％confidence interval)of the combination of serum FIZZ2 and IL-33 in the prognosis evaluation of AECOPD patients was 0.886(0.842～0.927),which was higher than 0.834(0.798～0.890)and 0.806(0.779～0.846)of single index detection,and the differences were significant(Z=4.255,4.697,all P＜0.05).Conclusion The serum levels of FIZZ2 and IL-33 are elevated in AECOPD patients,which are related to lung function.The combination of the two may have high predictive value for the survival prognosis of AECOPD patients.
chronic obstructive pulmonary diseasefound in inflammatory zone 2interleukin-33
万方数据
维普
